Objective: We sought to compare preoperative comorbidities in patients undergoing benign versus oncologic gynecologic surgeries. Methods: All cases of benign and malignant gynecologic surgeries in the National Surgery Quality Improvement Program (NSQIP) database between 2006-2012 were identified. Gynecologic cancers were grouped by site: uterus, ovary, cervix, and “other” including labia, vulva, vagina, pelvis, and retroperitoneum. Preoperative comorbidities were captured. Descriptive analyses were performed. 94,935 patients underwent gynecologic surgeries: 87.8% benign and 12.2% oncologic. The prevalence of cardiovascular disease, pulmonary disease, and neurologic disease differed between benign and oncologic groups (p < 0.001). In uterine, ovarian and other cancers, greater than 40% of patients had one or more comorbidities and > 5% had 2 or more, (p < 0.001). Gynecologic oncology patients were significantly older, had higher BMI, greater proportion black, and had more comorbidities than patients undergoing benign gynecologic surgery. Comorbidity profiles also differed significantly by type of gynecologic cancer. Preoperative and postoperative optimization, risk assessments, and appropriate reimbursement coverage should account for these baseline differences.